The Association Between Loneliness and Psychiatric Symptomatology in Older Psychiatric Outpatients

2021 ◽  
pp. 089198872110600
Author(s):  
Natasja Schutter ◽  
Tjalling J Holwerda ◽  
Hanna Kuipers ◽  
Rien H. L. Van ◽  
Max L. Stek ◽  
...  

purpose Loneliness in adults increases with age. Although loneliness has been found to be associated with psychiatric disorders and dementia, no information is available on prevalence of loneliness in older psychiatric patients. The aims of this study were to examine prevalence of loneliness in older psychiatric outpatients, including gender differences and associations with psychiatric disorders and social isolation. Methods Cross-sectional study in an outpatient clinic for geriatric psychiatry between September 2013 and February 2018. Interviews were done in 181 patients. Results 80% of participants were lonely. Loneliness was associated with having contacts in less social network domains, in women but not in men. There were no associations with DSM-IV-TR-classifications. However, loneliness was associated with higher scores on questionnaires for depression and cognitive function. Intensity of treatment did not differ significantly between lonely and non-lonely participants. Conclusion Loneliness is highly prevalent in older psychiatric outpatients, with men and women equally affected. Loneliness should be assessed in all older psychiatric patients, especially when they show high scores on symptom checklists or have a restricted social network.

2021 ◽  
pp. 025371762199953
Author(s):  
Bhavneesh Saini ◽  
Pir Dutt Bansal ◽  
Mamta Bahetra ◽  
Arvind Sharma ◽  
Priyanka Bansal ◽  
...  

Background: Normal personality development, gone awry due to genetic or environmental factors, results in personality disorders (PD). These often coexist with other psychiatric disorders, affecting their outcome adversely. Considering the heterogeneity of data, more research is warranted. Methods: This was a cross-sectional study on personality traits in psychiatric patients of a tertiary hospital, over 1 year. Five hundred and twenty-five subjects, aged 18–45 years, with substance, psychotic, mood, or neurotic disorders were selected by convenience sampling. They were evaluated for illness-related variables using psychiatric pro forma; diagnostic confirmation and severity assessment were done using ICD-10 criteria and suitable scales. Personality assessment was done using the International Personality Disorder Examination after achieving remission. Results: Prevalence of PD traits and PDs was 56.3% and 4.2%, respectively. While mood disorders were the diagnostic group with the highest prevalence of PD traits, it was neurotic disorders for PDs. Patients with PD traits had a past psychiatric history and upper middle socioeconomic status (SES); patients with PDs were urban and unmarried. Both had a lower age of onset of psychiatric illness. Psychotic patients with PD traits had higher and lower PANSS positive and negative scores, respectively. The severity of personality pathology was highest for mixed cluster and among neurotic patients. Clusterwise prevalence was cluster C > B > mixed > A (47.1%, 25.2%, 16.7%, and 11.4%). Among subtypes, anankastic (18.1%) and mixed (16.7%) had the highest prevalence. Those in the cluster A group were the least educated and with lower SES than others. Conclusions: PD traits were present among 56.3% of the patients, and they had many significant sociodemographic and illness-related differences from those without PD traits. Cluster C had the highest prevalence. Among patients with psychotic disorders, those with PD traits had higher severity of psychotic symptoms.


Author(s):  
Suganya Ganesan ◽  
Nitya Selvaraj ◽  
Vinoth Krishna Dass ◽  
Nalinidevi Jayabalan ◽  
Meher Ali Rajamohammad ◽  
...  

Background: In spite of many progresses in treatment of psychiatric disorders, medication nonadherence plays an important role in worsening of clinical condition and affects quality of life among psychiatric patients. There are numerous factors contributing for medication nonadherence among patients with mental illness. So, this study was conducted to assess psychiatric patients’ adherence of medication and to improve their quality of life with psychiatric disorder. The objectives of the study were to analyze impact of pharmacophilia and pharmacophobia on medication adherence among patients with psychiatric disorders at a tertiary care hospital and to assess quality of life among pharmacophilic and pharmacophobic patients.Methods: A cross-sectional study was conducted in outpatient psychiatric department for a period of two months. After obtaining informed voluntary consent, patient’s socio-demographic details, diagnosis, and treatment were recorded from prescription slip. Patients above 18yr age with psychiatric diagnosis as per International Classification of Diseases 10 (ICD-10) and receiving at least one psychotropic medication for >1 month were enrolled in study and assessed using: Drug attitude inventory classification (DAI-10); Medication Rating Scale (MARS); Quality of life enjoyment and satisfaction Questionnaire-Short Form (Q-LES-Q-SF).Results: Among 130 patients, 116 were pharmacophilic and 14 were pharmacophobic as per DAI-10 scale. 81.9% of pharmacophilic were adherent to prescribed medication assessed using MARS scale only 14.3% were pharmacophobic. The quality of life was better in pharmacophilic compared to pharmacophobic group (p=0.002) using Q-LES-Q-SF.Conclusions: This study concluded that pharmacophilic patients have higher adherence and good quality of life index compared to pharmacophobic. Proper counselling of pharmacophobic patients by psychiatrists could improve adherence and QOL.


2020 ◽  
Author(s):  
Siyun Zou ◽  
Zi-Han Liu ◽  
Xiaona Yan ◽  
Huan Wang ◽  
Yulong Li ◽  
...  

Abstract Background: The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with quality of life (QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Methods: This is a multicenter, cross-sectional study. Fatigue, depression, pain, insomnia symptoms, and QOL were assessed with standardized instruments. Results: A total of 1,063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1% - 50.1%). Analysis of covariance revealed that QOL was significantly lower in patients with fatigue compared to those without (P=0.011). Multiple logistic regression analysis revealed that more severe depression (OR=1.15, P<0.001), insomnia symptoms (OR=1.08, P<0.001) and pain (OR=1.43, P<0.001) were significantly associated with fatigue.Conclusions: Fatigue was common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.


Author(s):  
Maria R. Fernandes ◽  
Laura J. Lopes ◽  
Milla P. Rocha ◽  
Laís P. Almeida ◽  
Tânia R. Ferreira ◽  
...  

Background: The growing use of psychotropic drugs has been attributed to a higher frequency of psychiatric disorders diagnosed, interaction of new drugs on the pharmaceutical market, and new therapeutic indications of existing drugs. Given this scenario, the adequacy of the use of psychotropic drugs needs to be analyzed considering the scientific evidences. Objectives: To assess the appropriateness of drug prescriptions used by psychiatric patients in a public hospital in Sorocaba, according to the best available scientific evidence, and to describe the profile of this population. Methods: This cross-sectional study collected data from clinical records of patients with psychiatric disorders hospitalized in the psychiatric sector of the Sorocaba Hospital Complex, state of São Paulo, Brazil, between August 2015 and December 2016. The outcomes measured were: inappropriate use, presence of contraindication and serious or contraindicated drug interactions, according to the information available on the Dynamed® and Micromedex® 2.0 databases. Results: Patients were predominantly adults, and diagnosed with paranoid schizophrenia or bipolar affective disorder. Antipsychotics, benzodiazepines, and lithium accounted for 84.0% (n=2,938) of the 3,500 drugs prescribed for mental disorders. There were 2,157 (61.6%) inappropriate prescriptions, of which 81.9% corresponded to antipsychotics, benzodiazepines, and lithium. There were 1,712 prescriptions with drug combinations that risked causing drug interactions, predominantly involving antipsychotic use (67.0%). Conclusion: The study revealed a high number of inappropriate prescriptions, pointing to a need for greater prescription adequacy to ensure effective safe treatment for psychiatric patients.


2020 ◽  
Author(s):  
Siyun Zou ◽  
Zi-Han Liu ◽  
Xiaona Yan ◽  
Huan Wang ◽  
Yulong Li ◽  
...  

Abstract Background: The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with overall quality of life (overall QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Methods: This was a multicenter, cross-sectional study. Fatigue, depressive symptoms, pain, insomnia symptoms, and overall QOL were assessed with standardized instruments. Results: A total of 1,063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1% - 50.1%). An analysis of covariance revealed that overall QOL was significantly lower in patients with fatigue compared to those without (P=0.011). A multiple logistic regression analysis revealed that more severe depressive symptoms (OR=1.15, P<0.001), insomnia symptoms (OR=1.08, P<0.001) and pain (OR=1.43, P<0.001) were significantly associated with fatigue.Conclusions: Fatigue is common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on overall QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Siyun Zou ◽  
Zi-Han Liu ◽  
Xiaona Yan ◽  
Huan Wang ◽  
Yulong Li ◽  
...  

Abstract Background The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with overall quality of life (overall QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Methods This was a multicenter, cross-sectional study. Fatigue, depressive symptoms, pain, insomnia symptoms, and overall QOL were assessed with standardized instruments. Results A total of 1063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1–50.1%). An analysis of covariance revealed that overall QOL was significantly lower in patients with fatigue compared to those without (P = 0.011). A multiple logistic regression analysis revealed that more severe depressive symptoms (OR = 1.15, P < 0.001), insomnia symptoms (OR = 1.08, P < 0.001) and pain (OR = 1.43, P < 0.001) were significantly associated with fatigue. Conclusions Fatigue is common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on overall QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Dilnessa Fentie ◽  
Tariku Derese ◽  
Bekele Yazie ◽  
Yibeltal Getachew

Abstract Background Metabolic syndrome is a major public health challenge in both developed and developing countries. The burden of this disease is high, even in patients with psychiatric disorders. However, very little is known about the association between metabolic syndrome and psychiatric illness in Ethiopia. Therefore, the aim of this study was to investigate the magnitude of metabolic syndrome and its components among psychiatric clients. Methods A comparative cross-sectional study was undertaken between psychiatric patients and age—and sex-matched non-psychiatric controls at the Dilchora referral hospital. The study included 192 study participants (96 psychiatric patients and 96 non- psychiatric controls from general medical and surgical patients). The National Cholesterol Education Program: Adult Treatment Panel III criteria were used to diagnose metabolic syndromes. The data were cleaned and analyzed using the Statistical Package for Social Sciences, Version 21. All intergroup comparisons for continuous data were performed using an independent sample t-test, whereas categorical data were analyzed using the Chi-square test. Logistic regression analysis was used to identify the association between metabolic syndrome and the associated variables. Results The magnitude of metabolic syndrome among psychiatric patients was 36.5% (95%CI: 27.6, 47.4) compared to non-psychiatric control patients, 21.9% (95%CI: 13.5, 30.3), p = 0.02. The prevalence of MetS components, such as waist circumference (25.0% vs. 14.3%), lower-high density lipoprotein level (35.4% vs. 20.8%), higher systolic blood pressure (41.7% vs. 29.2%) and higher fasting blood glucose (40.6% vs. 18.8%) showed statistically significant differences between the exposed and non-exposed groups. Age greater than 50 years (AOR: 2.8, CI: 1.14, 20.0, p < 0.05); being female (AOR: 7.4, CI: 2.0, 27.6, p < 0.05), being urban residence (AOR: 6.4, CI: 2.2, 20.6, p < 0.05), ever alcohol intake (AOR: 5.3, CI: 1.3, 21.2), being physically inactive (AOR: 3.52, CI: 1.1, 12.9, p < 0.05) and family history of hypertension (AOR: 2.52, CI: 1.1, 12.2, p < 0.05) were independent predictors of metabolic syndrome (p < 0.05). Conclusions There is a high burden of metabolic syndrome and its components in patients with severe psychiatric disorders. Therefore, screening and mitigation strategies for metabolic syndrome and their components should be implemented in the management of psychiatric disorders.


2015 ◽  
pp. S101-S103 ◽  
Author(s):  
M. BIČÍKOVÁ ◽  
M. DUŠKOVÁ ◽  
J. VÍTKŮ ◽  
B. KALVACHOVÁ ◽  
D. ŘÍPOVÁ ◽  
...  

Reduced levels of vitamin or its metabolites have been reported in various psychiatric disorders. Insufficient levels of vitamin D in depressive patients have been confirmed by many authors, but there have been conflicting results in subjects with anxiety disorders. In the present cross-sectional study, levels of calcidiol were determined in groups of depressive men and women and in men and women with anxiety disorders and compared with age matched controls. Significantly lower levels of calcidiol were found in men and women with depression as well as in age matched patients with anxiety disorders.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037608
Author(s):  
Mario Martín-Sánchez ◽  
Richard Case ◽  
Christopher Fairley ◽  
Jane S Hocking ◽  
Catriona Bradshaw ◽  
...  

ObjectivesIn the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW.DesignRepeated cross-sectional study.SettingA sexual health centre in Melbourne, Australia.ParticipantsMSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW.Primary outcome measuresDemographic characterics, sexual practices and HIV/STI positivity.ResultsCompared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW.ConclusionsMSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amrita Ayer ◽  
Eddy R. Segura ◽  
Amaya Perez-Brumer ◽  
Susan Chavez-Gomez ◽  
Rosario Fernandez ◽  
...  

Abstract Background Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social network members (SNMs), participant perceptions of these network members’ opinions toward sexual health behaviors, and associations between network member characteristics and condomless anal intercourse (CAI). Methods In a 2017 cross-sectional study, a convenience sample of 565 MSM and trans women with HIV-negative or unknown serostatus was asked to identify three close SNMs; describe discussions about HIV and STI prevention with each; and report perceived opinions of condom use, HIV/STI testing, and partner notification of STIs. Generalized estimating equations evaluated relationships between SNM characteristics, opinions, and discussions and participant-reported CAI. Results Among participants who identified as MSM, 42.3% of key SNMs were perceived to identify as gay. MSM “never” discussed HIV and STI prevention concerns with 42.4% of heterosexual SNMs, but discussed them “at least once weekly” with 16.9 and 16.6% of gay- and bisexual- identifying SNMs, respectively. Among participants who identified as trans women, 28.2% of key SNMs were perceived as heterosexual; 25.9%, as bisexual; 24.7%, as transgender; and 21.2%, as gay. Trans women discussed HIV/STI prevention least with cis-gender heterosexual network members (40.2% “never”) and most with transgender network members (27.1% “at least once weekly”). Participants perceived most of their close social network to be completely in favor of condom use (71.2% MSM SNMs, 61.5% trans women SNMs) and HIV/STI testing (73.1% MSM SNMs, 75.6% trans women SNMs), but described less support for partner STI notification (33.4% MSM SNMs, 37.4% trans women SNMs). Most participants reported CAI with at least one of their past three sexual partners (77.5% MSM, 62.8% trans women). SNM characteristics were not significantly associated with participant-reported frequency of CAI. Conclusions Findings compare social support, perceived social norms, and discussion patterns of Peruvian MSM and trans women, offering insight into social contexts and sexual behaviors. Trial registration The parent study from which this analysis was derived was registered at ClinicalTrials.gov (Identifier: NCT03010020) on January 4, 2017.


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